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NPI Code Detail

MEDICARE: LAURIE G MOZIAN PHYSICAL THERAPIST

MEDICARE: LAURIE G MOZIAN PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist003130CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080003130CT02OTHERCTBLUE CARE HEALTH INS.
211243725OTHERCTCAQH

General Provider Information

NPI Number : 1841314051
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE G MOZIAN PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 100 PAUL TER
Second Line :
City : SOUTHINGTON
State : CT
Zip : 06489-4127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 45 MERIDEN AVE
Second Line :
City : SOUTHINGTON
State : CT
Zip : 06489-3214
Country : US
Telephone Number : 860-378-1234
Fax Number : 860-378-1160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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Directions to “ LAURIE G MOZIAN PHYSICAL THERAPIST” Practice Location

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